Daneshvar Medicine: Basic and Clinical Research Journal
Year:2005 | Volume:12 | Issue:57|Papers Count:16

Background: Neonatal sepsis, a major cause of death of neonates worldwide, is diagnosed by obtaining positive blood culture. The aim of this study was to determine common laboratory and clinical findings in the neonates who are suspected of sepsis. Method: The medical records of 200 infants, aged <30 days, with suspected infection, who were admitted in Mostafa Khomeini & Hazrate Zeynab hospitals in Tehran, were reviewed retrospectively. Based on clinical and biological findings, diagnosis was classified into 3 groups as follows: A: Proven sepsis with positive blood culture. B: Probable sepsis with negative blood culture but laboratory consistent with sepsis. C. Clinical sepsis without any positive culture or laboratory abnormalities. The validity of laboratory tests, which had been performed as sepsis workup, was compared with positive blood culture as gold standard test. Results: Of 200 infants 19 (9.5%) had positive blood culture. The most common causative organisms were klebsiella (5) staphylococous aurous (5) and staph Coagolase negative (5). Among laboratory tests, CRP with the specifity of 85% had the best sensitivity (79%) and negative predictive value (97%), but poor positive predictive value (36%). Conclusion: No laboratory tests can be used alone accurately as an early detection of septicemia.      

Introduction: The effect of simultaneous inhibition of production of nitric oxide and prostaglandin was investigated on modulation of vascular alpha.- 1 adrenoceptors responsiveness to phenylephrine in chronically inflamed rat knee joint. Method: Joint inflammation was induced by unilateral intraarticular injection of Freund's Complete Adjuvant (FCA) into right knee joint and experiments were done on the ipsilateral (right) and contra lateral (left) joints for 28 days. Blood flow measurements of the exposed joints were obtained using a Laser Doppler Flow meter (LDF). Results: Injection of FCA caused a significant increase in the diameter of both ipsilateral and contra lateral knee as compared with preinjection diameter. Topical application of phenylephrine (10-11 to 10-7 molar) in normal rats produced a dose-dependent vasoconstriction of the articular microvasculature. This constricted response was decreased in contra lateral knee joint of inflamed animals for 14 days, but had no significant effect on ipsilateral knee. After simultaneous treatment with Aminoguanidine (120 mg/kg i.p daily) and indomethacin (3 mg/kg i.p. daily) on the third and 14th day of FCA injection, vasoconstrictor responses to phenylephrine increased and returned to control value in contra lateral knee but not in ipsilateral knee. Conclusion: These data suggest that nitric oxide and prostaglandins seem to be involved in modulation of vasoconstrictor response of vascular alpha-1 adrenoceptors to phenylephrine.    

Introduction: Rearrangement of V, 0 & J segments of immunoglobulin heavy chain's gene with inserted or deleted nucleotides between rearranged segments make unique hyper variable regions (COR - 3).These regions can be used for evaluation of clonality & minimal residual disease using PCR. Method: 71 children with diagnosis of B - precursor acute lymphoblastic leukemia who were admitted in Ali Asghar & Children Medical Center Hospitals were studied. After DNA extraction of mononuclear cells of bone marrow aspirates, PCR was done using consensus primers for amplification of COR - 3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis & silver staining. Results: Eighty two percent of patients showed clonal rearrangement. Sixty nine, twenty - four and seven percent of patients showed monoclonal, biclonal & oligoclonal patterns, respectively. Conclusion: As a result of acceptable sensitivity assay, evaluation of MRD is possible.      

Introduction: Determining the prevalence of chemical composition of gallstone in any community is important because careful information of the. Incidence and recognition of risk factors can be helpful in preventing the gallstone, its effects and in saving expenses. Methods: 75 Patients with cholecystitis associated gallstone (60 women & 15 men) were selected determine the gallstone composition (cholesterol - pigmented) through FT-IR, concentration of serum cholesterol, triglycerid, calcium, phosphorous and FBS (before operation). Results: The mean age of patients was 55 years old. Cholesterol and pigmented gallstones frequencies were 76 and 24 percent in the patients, respectively. 83.3 percent of women and 46.6 percent of men had cholesterol gallstones. Furthermore 16.7 percent of women and 53.4 percent of men had pigmented gallstones. Significant correlations between sex, age, gallstone color and gallstone composition (p<0.05) were observed but there were no significant correlations between serum cholesterol, triglycerid, calcium, phosphorous, FBS mean and gallstone composition (N.S). Discussion: The results of this study suggest that the incidence of the cholesterol gallstone is more than pigmented gallstone which is in conformity with studies done in Western countries. Further careful studies for determining the risk factors and their prevention are recommended.      

Introduction: Otoacoustic emissions (OAEs) or preneural phenomenon of auditory system in normal cochlea are sounds that originate in the cochlea and spread through the middle ear and into the ear canal, where they can be measured by using a sensitive microphone. OAEs are sounds generated within the normal cochlea, either spontaneously or in response to acoustic stimulation. Driscoll et al. (2000) studied a total of 940 subjects (1880 ears), with a mean age of 6.2 years old. Results indicated significant sex and ear asymmetry effects on responses that were recorded in OAEs test. Prior 10 this study, Nozza et al. (1997) had suggested similar findings. Also, according to Merlet et al. (1995), Kalfa et al. (1997), Aidan et al. (1997), the amplitudes of emissions are often more robust in the right ear than the left one. The present study aimed at describing the range of OAEs (Spontaneous & Evoked Otoacoustic Emissions) values obtained from children. Being handicap and ear effect has also been investigated. Material and Methods: This analytical study was administered at the faculty of Tehran University of Medical Sciences. In this study, 100 boys between 7 to 11 years old (with a mean age of 9.1) were selected. All ears had middle ear pressure between -100 to +25 dapa, normal contra lateral acoustic reflexes and bilateral pure tone threshold<20 db HL at octave levels from 250 to 8000HZ. After otoscopy and pure tone audiometry, tympanometry was performed. Provided that normal results were obtained, OAEs test could be performed in a silent environment. Results: Regarding spontaneous OAES (SOAEs), 31 percent of subjects had spontaneous otoacoustic emissions. There were no significant differences (p>0.05) between mean amplitudes and mean frequency of emissions of the right and left ears. Similarly, in (DPOAEs) with different frequencies, no significant difference (p>0.05) was detected between mean amplitude of the right and the left ears. However, in (TEOAEs), the amplitudes of emissions in the right ear were more robust (p>0.05). Conclusion: The results of this study were quantitatively in accordance with the previous studies considering the otoacaustic emissions in children.  

Introduction: The aim of the present study is to find the effect of new herbal formulation of Euphorbia mysinites, Alkanna tinctoria and Peganum harmala combination on experimental Leishmaniasis in Balb/c mice. Material & Methods: To carry out this investigation, 6 groups of Balb/c mice (each with 8 mice) were selected as healthy negative control group, nontreated control group, group treated with glucantime, group treated with herbal drugs orally, group treated with herbal ointment and group treated with herbal ointment and syrup. All groups except the healthy negative control group were inoculated experimentally with 2x106 promastigotes by injection of the parasites in their tail. Diameter of the ulcers were measured weekly by caliper for 4 months. At the end of fourth month, all mice were killed and their spleen was investigated for the presence of the parasite. Results: The results indicated that Peganum harmala, Alkanna tinctoria, Euphorbia mysinites can affect sore and visceral forms of Leishmaniasis in the Balb/c mice. The death rates and relapse of infection in group treated with the herbal combination were less than other groups. In addition, in groups treated with glucantime, 25% of the mice were cured completely and 37.5% showed relapsing. Meanwhile in group treated with herbal combination orally, 50% of the mice were cured completely al1d 37.5 % showed relapsing. Moreover, in group treated with herbal ointment, 37.5 % of the mice were cured completely and 50% showed relapsing and in group treated with herbal ointment and syrup, 25 % of the mice were cured completely and 37.5% showed relapsing. During the experiment no side effect due to the herbal combination was observed in the treated mice. Conclusion: The present herbal combination in comparison with glucantime is more effective on murine Leishmaniasis, hence it could be suggested as a substitute for glucantime in the treatment of leishmaniasis.        

Introduction: ADHD is the most common behavioral problem in childhood. The studies identified the peak age of ADHD to be between three and four years old, and two thirds of children whose ADHD is later diagnosed would have been identifiable during the preschool years. However, most studies on this disorder have been carried out in school age populations, investigations are important in preschoolers from the view point of early detection, providing help and prevention of the complications. Methodology: This research is a descriptive- comparative study with the aim of finding out ADHD symptoms of preschool children at day care centers in Tabriz based on their parents and teachers reports, and upon DSM-III-R criteria. 273 children three to five years old were randomly chosen from 31 daycare centers and the questionnaires were completed by their parents and teachers separately. The statistical tests of the Mc Nemar, One-way ANOVA, Chi- Square and independent 'T' were used for data analysis. Results: The research findings showed that 10.3 percent of children based on their parents reports and 7.7 percent of them based on teachers' reports have the ADHD symptoms. Although comparison of their reports indicate that parents tend to report hyperactivity- impulsivity symptoms more than inattention symptoms, there were no significant differences between parents' and teachers' reports. Conclusion: While, there were no significant differences between parents' and teachers' reports, using both groups' reports may be useful in behavioral screening of preschool children aimed at identifying ADHD symptoms. Moreover, with regard to high percent of ADHD in preschool children, careful evaluation of ADHD symptoms and families' psychopathology are recommended.      

Introduction: Beta - thalassemia is a common single gene disease worldwide. However, the prevalence of beta-thalassemia in Iran has remained undetected. This study sought to find the estimated prevalence of beta-thalassemia in Bam. Method: A total of 5267 students (13 - 14 years old) in Bam were recruited for a prevalence study. A complete blood count was done for every subject. Those with microcytosis (MCV < 77f1) after iron therapy were studied with hemoglobin (Hb) high-performance liquid chromatography and hemoglobin electrophoresis to determine the levels of HbA2. Results: The overall prevalence of beta-thalassemia or trait (suspected to be involved) was 26% (136 persons). The prevalence of microcytosis was 17.3%. Conclusion: Determination of the prevalence of beta-thalassemia in Bam and other cities is useful for the genetic counseling and prenatal diagnosis of this disease.    

Introduction & Aims: Diabetic foot is one of .the late complications of diabetes mellitus. Prevalence of diabetic foot ulcer in patients with diabetic mellitus is more than 8%. Factors such as diabetic neuropathy, structural deformity, peripheral vascular disease, wound and infection of foot are precipitate of diabetic foot. Preventive care measures have an important role in reduction of diabetic foot. The aim of this descriptive and analytic study was to determine the effect of preventive care measures on diabetic foot in diabetic patients. Materials & Methods: A total of 620 patients were enrolled in the study through simple sampling. They completed the preventive care questionnaire, and a check list for diabetic foot assessment which included demographic questions, preventive care status and foot assessment. They also took part in interview and observation. Results: The results showed that the mean age was 53.47:t10 years. 41.3% of patients were male. The duration of the disease was 7.98:t6.3 years and 15.3% of the patients were trained in diabetic foot prevention. Moreover, the results showed a significant relationship between educational level, age, job and risk factors of diabetic foot, while there was no significant relationship between history of training in diabetic foot, sex and duration of diabetic mellitus. Conclusion: There is not adequate information and practice about preventive care measures for diabetic foot. Serious attention should be paid to training of diabetic patients by health care systems and mass media for the reduction of the hospitalization, care and rehabilitation expenses of the diabetic patients.    

Introduction: Over the past century, the Visual Evoked Potential (VEP) has gained widespread applications in vision research and clinical ophthalmology. The VEP helps us in the prognosis and distinctive diagnosis of eye diseases. Different parameters affect VEP, such as blurred and low acuity of the vision due to the eyes refractive errors which specially result from the myopia. In this study, the effect of myopia on the variation of the latency and amplitude of the P100 peak of the VEP has been investigated. Materials and Methods: Using various stimulation patterns, including the checker boards, vertical and horizontal bars, at two angles of 10 and 43 minutes, the effect of visual acuity, at four levels of 20/20, 20/40, 20/80, and 20/20, on the P100 peak of the VEP was investigated. Therefore, VEP signal was recorded by a Nicolet 1015 model machine and the different levels of visual acuities, as mentioned above, were induced by using suitable spherical lenses on a few normal and healthy volunteer individuals. Results: The results indicate that using the checker board patterns at small visual angel (10 minutes) shows the variation in the P100 parameter of the VEP better. It was also noted that, in this situation, by reducing the visual acuity the latency of the VEP is increased, while its amplitude is decreased significantly. Conclusion: In spite of the results obtained in this study, there is not a statistically significant quantitative relation between the visual acuity and the latency and amplitude of the P100 VEP peak that can be validated and relied on for diagnostic purposes. However, there are some variations. More accurate and detailed results on this topic needs further research on a bigger sample of individuals.